TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
ION MEDIA LICENSE COMPANY, LLC Doing Business As: ION MEDIA LICENSE COMPANY, LLC	Bianca Frye 601 Clearwater Park Road West Palm Beach, FL 33401 United States	+1 (561) 682-4110	BiancaFrye@ionmedia.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

ION MEDIA LICENSE COMPANY, LLC

Doing Business As: ION MEDIA LICENSE COMPANY, LLC

Bianca Frye

601 Clearwater Park Road

West Palm Beach, FL 33401

United States

+1 (561) 682-4110

BiancaFrye@ionmedia.com

Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
The Preparer is same as the reimbursement contact.

Broadcaster Information and Transition Plan

Question	Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information.	Yes
Briefly describe transition plan	Install and operate from broadband interim antenna on pre repack channel utilizing current non retunable transmitter and existing transmission line. Replace current top mount antenna, transmission line and transmitter for operation on post repack channel

Transmitters

Section	Question	Response
Transmitter Related Expenses	Do you have transmitter related expenses?	Yes

Primary Transmitter

Existing Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmitter currently shared with another station?	No
	Is this transmitter currently in operating condition?	Yes
Existing Transmitter Manufacturer and Type	Manufacturer
	Model	DCX
	Year	2003
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	40 kW

Primary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Manufacturer
	Model	THU9-16 EVO
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	25.5 kW
	Justification for New Transmitter	See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	No
	Transformer (480V)	Yes
	Power	300 kVA
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	5 tons
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	Yes
	Size	3200.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
RF Interconnect	Interconnect between RF System and transmission line
Removal of Existing Equipment	Removal of existing transmitters and equipment / Site Prep

Antennas

Section	Question	Response
Antenna Related Expenses	Do you have antenna related expenses?	Yes

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing antenna shared with another station or stations?	No
	Is the existing antenna directional?	No
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	Yes
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Top
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels	N/A
	Design power capacity in use	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Other Antenna Type	N/A
	ERP:	257.0 kW
	Manufacturer
	Model	TFU-24GTH-R 04
	Year	2003

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	No
	Is antenna directional?	No
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Types	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Top
	Polarization	Elliptical
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	218.0 kW
	Manufacturer
	Model	TFU-21JTH/VP-R-O6
	Year	2019
	Justification for New Antenna	Current slot antenna can not be re-channeled. Please refer to the SOW tab in the attached AT Repack Cost Estimate Worksheet as WXPX is planning on a separate antenna stacked above the broadband antenna.

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?
	Type
	Number of channels supported	N/A
	Frequencies of channels supported	N/A
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	N/A
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	Single Channel
	Feed Line Size	6 1/8 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Input Complex	Includes the necessary line sections, hangers, elbows, and engineering design to to get the line from inside the tower up through to the antenna input located at the top of the stack.

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	No
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Slot
	Number of Stations Supported	1
	Number of Panels/Bays	8
	Lower Limit	470.00 MHz
	Upper Limit	698.00 MHz
	Design power capacity in use	25.0 %
	Other Antenna Type	N/A
	ERP:	100.0 kW
	Manufacturer
	Model	TFU-8WB-R C160
	Year	2018
	Justification for New Antenna	Interim antenna needed to keep station on air during repack channel transition.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	B
	Feed Line Size	4 1/16 inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	No
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Interim Antenna Rent	ATC is working with 4 repack stations on the Riverview 1 tower. The interim Main side mount antenna will allow the broadcasters to minimize their OTA disruption, maintain their coverage contour, complete the tower work in a safe and timely manner.

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	Yes

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing transmission line shared with another station or stations?	No
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Rigid
	Diameter	6 1/8 inches
	Other Diameter	N/A
	Segment Length	19 1/2 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1650 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Rigid
	Diameter	6 1/8 inches
	Other Diameter	N/A
	Segment Length	19 1/2 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1705 feet per run
	Justification for New Transmission Line	See attached Transmission Line Exhibit

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Sweep existing transmission line	Sweep existing transmission line

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	Yes

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Is this tower consider Complex?	Candelabra
	Is this tower currently shared with any other stations?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	No
	Is tower documented for structural analysis?	Unknown
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1057473
Coordinates (NAD83)	Latitude (NAD83)	27° 49' 10.8" N-
	Longitude (NAD83)	082° 15' 38.0" W-
	Overall Structure Height	1592.83 feet
	Support Structure Height	1443.88 feet
	Ground Elevation Above Mean Sea Level (AMSL)	75.13 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Towers, LLC.
	Date Constructed	09/07/2011

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID	Call Sign	Service
74200	WWRM	FM
23078	WMTX	FM
11290	WTSP	DTV
63984	WFUS	FM
53819	WMOR-TV	DTV
29732	WFLZ-FM	FM
66013	WPOI	FM
11125	WCLF	DTV
47459	WMNF	FM

Primary Tower

Tower Modification Costs

Section	Question	Response
Engineering Study	Please what type of engineering study is required, if any:	Study needed for undocumented/poorly documented tower
Tower Reinforcements	Please select whether tower reinforcements are needed:	Major Reinforcements needed

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	Candelabra
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Tower Load Study	Rigorous Structural analysis to access the structural capacity and modifications needed to accommodate the repacked equipment.
Construction project management Tower Modification reinforcements and facilities	(80) hours on Modification project management
Ground and Building A and E Permit Drawing Package	The generation of a construction drawing package for one (1) broadcasters/customers.
Interim antenna and transmission line installation	Rigging cost for the new side mount interim antenna and transmission line installation
Tower Permit Drawing Package	The generation of a construction drawing package for one (1) broadcasters/customers.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	95
	Explanation	Required by tower landlord. 94.8hrs x $100hr
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	NEPA Section 106 environmental review	Yes
	Environmental Assessment	Yes
	ASR Modification	Yes
	FAA Consultation (including preparation of FAA Form 7460)	Yes
	Negotiation of Lease and other Matter for Shared Locations	Yes
	Prepare or Review FCC Form 399 for Reimbursement	Yes
	Address transition timing and coordination issues w/ other stations and wireless providers	Yes
RF Field Engineering Services	Comprehensive coverage verification via field study	Yes
	RF exposure measurements	Yes
	Additional Field Engineering Service	No
	Number of Days	N/A
	Justification	N/A

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Migratory Bird Assessment and Permitting	Migratory Bird Assessment / Permitting (if needed) (Cost per customer)
RF System Test	RF System Test per landlord
Site Coordination Meeting	Site coordination meetings with all broadcasters, contractors and vendors involved with the site project.

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	Is Remediation needed?	No
Facility Expenses	Name	N/A
	Other Distributed Transmission System Expenses Not listed	N/A
	Name	N/A
	Is Notification of a Medical Facility required as a result of DTV broadcasting?	Yes
Permit and Filing Costs	Local Zoning	Yes
	Non-zoning permits	Yes
	BLM or NFS Coordination	No
	FCC Construction Permit Minor Change	Yes
	FCC License to Cover Application	Yes
	FCC Special Temporary Authority Application	Yes
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	Yes
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	Yes
	Does this relocation require Equipment Storage?	Yes
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Name	Description
Obtain building permits from local zoning authorities	The cost of preparation and submission of the needed forms for permits, on behalf of the one broadcaster for jurisdictional permits, required for electrical, building and other tasks assoc. with the install of the the equipment in the transmitter spaces.

Cost Information

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$1,101,085.85	$815,752.85	N/A	$740,130.19	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Primary Transmitter THU9-16 EVO	$1,101,085.85	$815,752.85		$740,130.19
Removal of Existing Equipment	$37,597.41	$37,597.41	Please see Skyline Equipment Removal EST21330 and Rohde Schwarz Quote #255556.0	$37,597.41	N/A
RF Interconnect	$29,038.44	$29,038.44	Please see attached Rohde & Schwarz Quotes #274076.0 and #25553.1	$29,038.44	N/A
Other -- Building Addition Size: 3200.0	$30,400.00	$30,400.00	See AT exhibit for more information.	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$654,117.00	N/A	$628,144.34	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$45,350.00	Please see Total Electric Service Quote #30072019	$45,350.00	N/A
5 Ton system	$20,250.00	$19,250.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Removal of Existing Equipment	Component Description: Cost of permit drawings and to decommission old heat exchangers. Supporting documentation is attached. This invoice has been paid. Amount: $10,097.41 Component Description: Cost to remove old transmitter equipment. Supporting documentation is attached. Amount: $27,500.00
RF Interconnect	Component Description: Cost of additional equipment needed for RF Interconnect. Supporting documentation is attached. This invoice has been paid. Amount: $1,040.00 Component Description: Cost of equipment needed for RF Interconnect. Supporting documentation is attached. This invoice has been paid. Amount: $27,998.44
Other -- Building Addition Size: 3200.0	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: 35% "upon proof of performance less $1,000 deposit" cost of new transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $217,741.29 Component Description: 2nd "milestone" 30% payment on Rohde & Schwarz transmitter. Supporting documentation attached. This invoice has been paid. Amount: $188,922.95 Component Description: 3rd "milestone" 35% payment on Rohde & Schwarz transmitter. Supporting documentation attached. This invoice has been paid. Amount: $220,410.10 Component Description: "Deposit" payment on Rohde & Schwarz transmitter. Supporting documentation attached. This invoice has been paid. Amount: $1,070.00
Transformer 3 phase/480v - 300 KVA	Component Description: Balance payment for installation of electric equipment for transmitter package. Supporting documentation is attached. Amount: $2,000.00 Component Description: Cost of installation for electric equipment for transmitter package. Supporting documentation is attached. Amount: $43,350.00
5 Ton system	Information not provided.

Cost Information

Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$533,519.22	$352,485.86	N/A	$352,485.86	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Interim Antenna TFU-8WB-R C160	$207,253.80	$109,388.08		$109,388.08
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	$89,400.00	$4,124.37	Please see Dielectric Quote #900070CMZ WXPX ION INTERIM with Change Order. Antenna cost was already reimbursed under other interim antenna. Plus sales tax This amount if only for Dieletric Quote for Interim Chain Mount Kit	$4,124.37	N/A
Interim Antenna Rent	$41,548.80	$41,548.80	Please see American Tower WXPX Temporary Site License 2019, plus tax	$41,548.80	N/A
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed)	$10,950.00	$601.91	Please see Dielectric Quote #900070CMZ WXPX ION INTERIM with Change Order. Cost was already reimbursed under other interim elbow complex. Plus sales tax for interim elbow complex	$601.91	N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$11,788.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Please see Dielectric Quote #900070CMZ WXPX ION INTERIM with Change Order	$11,788.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 8 bay,, 250 kW input, directional,, elliptically or circularly polarized	$44,925.00	$44,925.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Please see attached Dielectric Quote #900070CMZ WXPX ION INTERIM with Change Order	$44,925.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A
Primary Antenna TFU-21JTH/VP-R-O6	$326,265.42	$243,097.78		$243,097.78
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$11,357.03	Please see Dielectric quote #DMS038-3. Plus sales tax	$11,357.03	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	$289,500.00	$207,605.33	Main antenna and wedding cake. V-Pol cost not included in reimbursement request. Please see attached Dielectric Quote #DMS038-3-WXPX. Plus sales tax	$207,605.33	N/A
Input Complex	$17,735.42	$17,735.42	Please see Dielectric quote #DMS038-3. Plus sales tax	$17,735.42	N/A

Components

Actual Information Description	File Name
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	Component Description: Cost of chain mounts for interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $1,326.00 Component Description: Sales tax for interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $2,798.37
Interim Antenna Rent	Component Description: ATC one-time tower rental during market repack period for interim antenna. Supporting documentation and cover letter regarding payment is attached. This one-time payment has been paid. Amount: $38,400.00 Component Description: Cost of tax for ATC one-time tower rental during market repack period for interim antenna. Supporting documentation and cover letter regarding payment is attached. This invoice has been paid. Amount: $3,148.80
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed)	Component Description: Sales tax for interim elbow equipment. Supporting documentation is attached. This invoice has been paid. Amount: $601.91
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Component Description: Cost of interim elbow complex. Supporting documentation is attached. This invoice has been paid Amount: $9,663.00 Component Description: Additional cost of interim elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $2,125.00
UHF - High Power, Side Mount, basic slot antenna, 8 bay,, 250 kW input, directional,, elliptically or circularly polarized	Component Description: Cost of interim broadband antenna. Supporting documentation is attached. This invoice has been paid Amount: $44,925.00
Sweep test of existing antenna	Component Description: Cost of repack sweep for interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $6,400.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Component Description: 25% "with order" payment for elbow complex. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $2,677.50 Component Description: 10% "after sweep" payment for elbow complex. Supporting documentation attached. This invoice has been paid. Amount: $1,071.00 Component Description: Cost of sales tax for main elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $647.03 Component Description: 25% "with order" for primary elbow complex. Supporting documentation is attached. Amount: $2,677.50 Component Description: 65% "prior to shipment" payment for elbow complex. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $6,961.50
Sweep test of existing antenna	Component Description: 25% "with order" payment for repack sweep. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $1,600.00 Component Description: 10% "after sweep" payment for repack sweep. Supporting documentation is attached. This invoice has been paid. Amount: $640.00 Component Description: 65% "prior to shipment" payment for repack sweep. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $4,160.00 Component Description: 25% "with order" for primary repack sweep operations. Supporting documentation is attached. Amount: $1,600.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	Component Description: 65% "prior to shipment" payment for main antenna and wedding cake. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $127,237.50 Component Description: Sales tax payment for main antenna and wedding cake. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $11,855.33 Component Description: 25% "with order" payment for main antenna and wedding cake. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $48,937.50 Component Description: 10% "after sweep" payment for main antenna and wedding cake. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $19,575.00 Component Description: 25% "with order" for primary antenna and wedding cake. Supporting documentation is attached. Amount: $44,756.25
Input Complex	Component Description: Cost of sales tax for main input complex. Supporting documentation is attached. This invoice has been paid. Amount: $1,010.42 Component Description: 65% "prior to shipment" payment for input complex. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $10,871.25 Component Description: 25% "with order" payment for input complex. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $4,181.25 Component Description: 10% "after sweep" payment for input complex. Supporting documentation attached. This invoice has been paid. Amount: $1,672.50 Component Description: 25% "with order" for input complex. Supporting documentation is attached. Amount: $4,181.25

Cost Information

Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$350,810.00	$329,867.60	N/A	$321,914.49	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Primary Transmission Line	$350,810.00	$329,867.60		$321,914.49
Rigid Transmission Line - copper, 6 1/8"	$344,410.00	$323,467.60	Please see Dielectric Quote #DMS038-3 and Dielectric Quote #1930636	$321,914.49	N/A
Sweep existing transmission line	$6,400.00	$6,400.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 6 1/8"	Component Description: 25% "with order" payment for transmission line. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $75,478.03 Component Description: 10% "after sweep" payment for cut pieces of transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $1,159.50 Component Description: Cost for additional pieces of cut transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $4,955.50 Component Description: 10% "after sweep" payment for transmission line. Supporting documentation attached. This invoice has been paid. Amount: $27,478.09 Component Description: Cost of sales tax for main transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $16,600.50 Component Description: 25% "with order" for primary transmission line and transmission line cut pieces. Supporting documentation is attached. Amount: $79,659.28 Component Description: 65% "prior to shipment" payment for transmission line. Supporting documentation and explanation of variance attached. This invoice has been paid. Amount: $196,242.87
Sweep existing transmission line	Information not provided.

Actual Information Description

File Name

Rigid Transmission Line - copper, 6 1/8"

Component Description:: 25% "with order" payment for transmission line. Supporting documentation and explanation of variance attached. This invoice has been paid.
Amount:: $75,478.03

Component Description:: 10% "after sweep" payment for cut pieces of transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $1,159.50

Component Description:: Cost for additional pieces of cut transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $4,955.50

Component Description:: 10% "after sweep" payment for transmission line. Supporting documentation attached. This invoice has been paid.
Amount:: $27,478.09

Component Description:: Cost of sales tax for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $16,600.50

Component Description:: 25% "with order" for primary transmission line and transmission line cut pieces. Supporting documentation is attached.
Amount:: $79,659.28

Component Description:: 65% "prior to shipment" payment for transmission line. Supporting documentation and explanation of variance attached. This invoice has been paid.
Amount:: $196,242.87

Sweep existing transmission line

Information not provided.

Cost Information

Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$1,087,700.00	$1,087,217.23	N/A	$910,727.23	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Primary Tower GTOWER	$1,087,700.00	$1,087,217.23		$910,727.23
Tower Permit Drawing Package	$4,700.00	$4,700.00	See AT Exhibit for more information.	$4,700.00	N/A
Tower Load Study	$15,000.00	$15,000.00	See AT exhibit for more information.	$15,000.00	N/A
Ground and Building A and E Permit Drawing Package	$4,700.00	$4,700.00	See AT exhibit for more information.	N/A	N/A
Major tower reinforcement/modifications	$421,000.00	$150,000.00	See AT Exhibit for more information.	N/A	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$13,416.80	See AT Exhibit for more information. Cost estimate includes sales tax.	$13,416.80	N/A
Construction project management Tower Modification reinforcements and facilities	$10,000.00	$10,000.00	See AT exhibit for more information.	$5,410.00	N/A
Interim antenna and transmission line installation	$185,000.00	$185,000.00	Please see Worldwide Communications Quote #S-19-936_Updated. $20,000 deposit was incorrectly submitted under Complex Tower section (Worldwide invoice #2011)	$167,800.00	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$704,400.43	Please see Coast to Coast Tower Services Agreement. Plus Licensing and permit fees on Coast to Coast bill #2329. Cost includes $20,000 deposit on Worldwide bill #2011, that should have been submitted under interim antenna installation costs.	$704,400.43	N/A

Components

Actual Information Description	File Name
Tower Permit Drawing Package	Component Description: Cost of tower permit drawing package. Supporting documentation is attached. This invoice has been paid. Amount: $4,700.00
Tower Load Study	Component Description: Cost of ATC broadcast structural. Supporting documentation is attached. This invoice has been paid. Amount: $9,500.00 Component Description: Cost of ATC broadcast structural. Supporting documentation is attached. This invoice has been paid. Amount: $5,500.00
Ground and Building A and E Permit Drawing Package	Information not provided.
Major tower reinforcement/modifications	Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: Cost of ATC broadcast tower mapping. Supporting documentation is attached. This invoice has been paid. Amount: $13,416.80
Construction project management Tower Modification reinforcements and facilities	Component Description: Cost of ATC capital contribution and project management fee. Supporting documentation is attached. This invoice has been paid. Amount: $5,410.00
Interim antenna and transmission line installation	Component Description: Cost of engineering review for interim rigging plan. Supporting documentation is attached. This invoice has been paid. Amount: $2,800.00 Component Description: Balance due for interim antenna tower services. Supporting documentation is attached. Amount: $41,250.00 Component Description: 75% deposit for interim antenna tower services. Supporting documentation is attached. This invoice has been paid. Amount: $123,750.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Component Description: Down payment associated with securing tower service. Note that amount is not additional to cost of tower rigging and will be deducted from total cost of tower rigging at the time it is quoted. Supporting documentation attached. This invoice has been paid. Amount: $20,000.00 Component Description: Progress payment for tower services. Supporting documentation is attached. Amount: $100,000.00 Component Description: Balance payment for tower services. Supporting documentation is attached. Amount: $91,000.00 Component Description: Deposit payment for tower services. Supporting documentation is attached. This invoice has been paid. Amount: $218,719.00 Component Description: Progress payment for tower services. Supporting documentation is attached. This invoice has been paid. Amount: $50,000.00 Component Description: Progress payment for tower services. Supporting documentation is attached. This invoice has been paid. Amount: $65,000.00 Component Description: Cost of weather delays during tower services. Supporting documentation is attached. Amount: $17,500.00 Component Description: Cost of licensing and permit fees for tower services. Supporting documentation is attached. This invoice has been paid. Amount: $42,181.43 Component Description: Progress payment for tower services. Supporting documentation is attached. Amount: $100,000.00

Cost Information

Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$183,158.00	$151,085.00	N/A	$15,847.99	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Outside Professional Services	$183,158.00	$151,085.00		$15,847.99
Migratory Bird Assessment and Permitting	$438.00	$438.00	See AT exhibit for more information.	N/A	N/A
RF Exposure Measurements	$21,050.00	$3,750.00	See AT exhibit for more information.	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	$4,742.99	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$1,500.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$125.00	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	See AT exhibit for more information.	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	N/A	N/A
Project management of the transition	$15,010.00	$9,480.00	See AT Exhibit for more information.	$9,480.00	N/A
Site Coordination Meeting	$1,500.00	$1,500.00	See AT exhibit for more information.	N/A	N/A
RF System Test	$5,000.00	$5,000.00	See AT exhibit for more information.	N/A	N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	$2,105.00	$2,000.00	N/A	N/A	N/A
ASR modification (prepare FCC Form 854)	$2,105.00	$167.00	See AT exhibit for more information.	N/A	N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet	$10,520.00	$10,000.00	N/A	N/A	N/A
NEPA Section 106 environmental review, if needed	$6,310.00	$6,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,500.00	N/A	N/A	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Migratory Bird Assessment and Permitting	Information not provided.
RF Exposure Measurements	Information not provided.
Comprehensive coverage verification via field study, if needed	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Invoice for WXPX's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Hourly supporting documentation and invoice attached. Amount: $4,742.99 Component Description: Invoice for station's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff and has provided corrected supporting documentation. Amount: $4,837.97
Prepare request for Special Temporary Authorization	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Cost of RF consultant preparation of engineering section of FCC Form 2100. Hourly supporting documentation attached. This invoice has been paid. Amount: $1,500.00
Perform engineering study for new channel assignment and antenna development	Component Description: Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid. Amount: $62.50 Component Description: Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid. Amount: $62.50
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Information not provided.
Project management of the transition	Component Description: Cost of project management charged by landlord. Supporting documentation is attached. This invoice has been paid. Amount: $9,480.00
Site Coordination Meeting	Information not provided.
RF System Test	Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	Information not provided.
ASR modification (prepare FCC Form 854)	Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet	Information not provided.
NEPA Section 106 environmental review, if needed	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations	Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.

Cost Information

Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$91,190.00	$84,585.00	N/A	$13,716.02	N/A
Total for all systems	$3,347,463.07	$2,820,993.54	N/A	$2,354,821.78	N/A
Other Expenses	$91,190.00	$84,585.00		$13,716.02
Obtain building permits from local zoning authorities	$1,000.00	$1,000.00	Please see American Tower Quote WXPX 23506 Riverview Broadcast Permitting	$1,000.00	N/A
MVPD Notification of Channel Change	$2,000.00	$2,000.00	N/A	$2,000.00	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized.	N/A	N/A
Equipment Storage	$10,000.00	$10,000.00	N/A	N/A	N/A
Equipment Delivery and Handling Charges	$10,000.00	$10,000.00	N/A	$1,562.97	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$15,000.00	$15,000.00	N/A	$4,153.05	N/A
Non-zoning permits	$15,000.00	$15,000.00	N/A	N/A	N/A
Local Zoning	$25,000.00	$25,000.00	N/A	N/A	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$190.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$325.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 minor change CP application	$1,110.00	$1,070.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$5,000.00	N/A	$5,000.00	N/A

Components

Actual Information Description	File Name
Obtain building permits from local zoning authorities	Component Description: Cost to obtain permits from local zoning authorities. Supporting documentation is attached. This invoice has been paid. Amount: $1,000.00
MVPD Notification of Channel Change	Component Description: Cost of MVPD notifications for repack channel change. Supporting documentation is attached. This invoice has been paid. Amount: $2,000.00
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Information not provided.
Equipment Delivery and Handling Charges	Component Description: Cost of freight for chain mounts for interim antenna. Supporting documentation and justification for expedited freight attached. This invoice has been paid. Amount: $276.82 Component Description: Cost of freight for additional pieces of cut transmission line. Supporting documentation and justification for expedited shipping attached. This invoice has been paid. Amount: $1,286.15
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Cost of dumpster rental and equipment disposal. Supporting documentation is attached. This invoice has been paid. Amount: $1,863.15 Component Description: Additional cost for onsite dumpster rental. Supporting documentation is attached. This invoice has been paid. Amount: $65.00 Component Description: Additional cost for onsite dumpster rental. Supporting documentation is attached. This invoice has been paid. Amount: $275.00 Component Description: Cost of onsite dumpster rental and disposal. Supporting documentation is attached. This invoice has been paid. Amount: $355.80 Component Description: Cost of onsite dumpster rental and disposal. Supporting documentation is attached. This invoice has been paid. Amount: $809.60 Component Description: Cost of onsite dumpster rental and disposal. Supporting documentation is attached. This invoice has been paid. Amount: $784.50
Non-zoning permits	Information not provided.
Local Zoning	Information not provided.
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
FCC Filing Fees - Form 2100 minor change CP application	Information not provided.
DTV Medical Facility Notification	Component Description: Cost of medical notifications for repack channel change. Supporting documentation is attached. This invoice has been paid. Amount: $5,000.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$3,347,463.07	$2,820,993.54	$2,354,821.78

Reimbursement Status

Question	Response
The facility has ceased operating on its pre-auction channel.	Yes
Construction of final facilities or all necessary modifications are complete.	No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator.	No

Certification

Section	Question	Response
Submission of Estimated Expenses Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD). The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Mario Vasquez Vice President - Finance, Operations 11/13/2020

Section

Question

Response

Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).
The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.
The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Mario Vasquez

Vice President - Finance, Operations

11/13/2020

Certification

Section	Question	Response
Submission of Actual Cost Documentation Statements	WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).
The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) . The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Mario Vasquez Vice President - Finance, Operations 11/13/2020

Section

Question

Response

Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.
The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .
The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Mario Vasquez

Vice President - Finance, Operations

11/13/2020

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components